Online Journal of Nursing Informatics (OJNI), 12, (3). Page 1 of 5
An Essay:
A panda, a monkey, a banana, and an informatics nurse
Part 1: A mash-up of concepts
INVITED EDITORIAL
by
Theresa L. Calderone, EdD, MEd, MSN, RN
Citation:
Calderone, T. (2008). An Essay: A panda, a monkey, a banana, and an informatics nurse: Part 1: A mash-up of
concepts. Online Journal of Nursing Informatics (OJNI), 12, (3). Available at http:ojni.org/12_3/terri.htm
“A wonderful harmony arises from joining
together the seemingly unconnected” (Robinson,
1987). We may think of thinking as a skill to
connect ideas. While previously unconnected
thoughts stimulate new thinking, our tendency to
rely on the same ideas repeatedly will lessen our
ability to generate new ideas and inhibit our
creativity and new ways of looking at things
(vonOech, 1998). A Greek philosopher named Heraclitus challenges us to not only
think, but requires that we change the way we think (Robinson, 1987). This essay
presents a mash-up of new ways of thinking for the transformation of how informatics
nurses need to connect ideas in today’s health care environment.
A
mash-up is defined as something that combines two or more sources of
information to form a new view of the information or present a new idea or
concept (Holdener, 2008). Mash-ups can be a physical collection of data, a website,
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or computer application. For example, combining vacation photos with a map of the
destination forms is a simple mash-up. By adding together (mashing-up) your vacation
photos, maps, information about the destination, and stories about the people you
have met, creates a more complex mash-up.
M
y daydreaming and inattention in meetings has increased lately. Perhaps it
is because I like to think about more interesting topics than, let’s say MRSA
or medication reconciliation. And as an informatics nurse involved in clinical
operations, I pondered about my skills and ability of trying to interpret technical jargon
into an understandable form of the English language for my less technical clinical
colleagues. I struggle with finding the best form of communication to explain
technology concepts that most clinicians would understand and can best apply to their
work situation.
I
am reminded of Richard Nisbett’s 2003 book, The Geography of Thought, How
Asians and Westerners Think Differently…and Why. His frequently quoted study is
the one where he shows a graphic of a panda, a monkey, and a banana to both
American and Asian students. He proceeds to ask them to place two of the objects
together. Nisbett found that Asian students tend to pick the monkey and the banana
while American students pick the monkey and the panda. He concludes that Asian
students look for relationships, for example, a monkey eats bananas. American
students tend to group the panda and monkey together and categorize, the panda and
monkey are both mammals (Nisbett, 2003).
C
ategories are sometimes learned by applying rules to features of an object or
concept. Rule-making seems to be less characteristic of Asians (Nisbett,
2003). I wondered if I would be more effective in my translations of how technology
works if I adopted a more Eastern style. To think more deeply about how things relate
instead of the tendency to categorize, would help to generate new ideas about how to
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encourage the adoption of some of the complex technologies that are introduced into
the health care environment.
N
isbett (2003) also writes that categories are usually described by nouns while
relationships are more tacit or implied and are described with verbs. Imagine
learning new technologies like we learn to ride a bike! Relationship thinking is more
active and complex and may provide an avenue for informatics nurses to model critical
thinking to nurses new to the nursing profession or those inexperienced in the art and
science of nursing informatics.
T
he second concept in this mash-up is the tipping point. Gladwell (2002) writes
that the best way to understand a trend, a transformation, or the emergence of
something is to think of them as an epidemic. Critical mass is reached when a social
group begins to behave differently and an idea or concept becomes contagious and
spreads just like a virus to the larger group. The moment that everything changes all
at once is the tipping point (Gladwell, 2002).
R
eferring back to what Nisbett (2003) wrote about categorization versus
relationship, Gladwell (2002) may encourage you to reframe or rethink your
categorization rule about epidemics. Most of us think about contagiousness as the
spread of, for example, colds, the flu, or HIV and not about how informatics nurses can
behave in a way that creates contagion for technology trends, nursing transformation,
or the emergence of new interventions.
G
ladwell (2002) has transformed my thinking about the tipping point. I grew up
in a rural area and one form of entertainment was to try to introduce city
friends to the art of cow tipping. The tipping point to us was when we convinced our
friends that it was possible to tip a cow. I think it was our strategy to lure our friends
into visiting us. We would make up colorful stories about how awesome it was see a
cow fall. In retrospect, imagine the contagion we spread among our distant friends.
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They told their friends and their friends told their friends about wanting to go to the
farm to do something way cool like tip a cow. This was before the age of text
messaging! Of course we had to make up some excuse for not tipping a cow when
they came to visit. A total let down to our friends. As an informatics nurse, I learned
from these earlier experiences to not lead colleagues toward technology that does not
deliver what it was designed to do. False pretenses about the value of technology will
destroy the contagion and motivation of clinicians who rely on us to guide them
towards a culture of automated support of clinical activities.
I
can only imagine the contagion informatics nurses could create about technology
and innovation for clinical nursing if only we put our minds and imagination into it.
The Technology Informatics Guiding Education Reform Initiative (T.I.G.E.R.) is helping
our specialty by creating the momentum for critical mass by advancing the national
health care information technology (The T.I.G.E.R. Initiative, 2008).
It is interesting how we can tie Gladwell, T.I.G.E.R., and Nisbett, together to
form a complex informatics concept. Gladwell (2002) writes that little things can make
a big difference. T.I.G.E.R. (2008) describes one of the advanced competencies for
an experienced clinical nurse is the ability to see relationships among data elements
which are the smallest unit of information. And Nisbett (2003) explains the art of
relationship thinking.
T
his mash-up of ideas and concepts is something that I envision as one role of
the informatics nurse of the future – now. The act of synthesizing ideas,
concepts, innovations, and thinking in small ways will make big differences in the art,
science, and practice of evidence based nursing practice. It is our responsibility to
facilitate and advance conceptual thinking, to enable clinical nurses to leverage
information, and to empower nurses to use technology safely (The T.I.G.E.R. Initiative,
2008) in the care of patients.
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References
Gladwell, M. (2002). The tipping point, how little things can make a big difference.
New York, NY: Little, Brown, and Company.
Holdener, A.T. (2008). Ajax: the definitive guide. Safari Books On Line: O’Reilly
Media.
Nisbett, R.E. (2003). The geography of thought, how asian and westerners think
differently…and why. New York, NY: Free Press.
Robinson, T.M. (1987). Heraclitus. Ontario, Canada: University of Toronto Press.
The T.I.G.E.R. Initiative (2008). Technology informatics guiding education reform.
Retrieved May 4, 2008, from https://www.tigersummit.com.
van Oech, R. (1998). A whack on the side of the head: how you can be more creative
nd
(2 ed.). New York, NY: Warner Books, Inc.